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The Annals of Thoracic Surgery, Vol 41, 492-497, Copyright © 1986 by The Society of Thoracic Surgeons
LL Cherup, RD Siewers and JW Futrell
Anterolateral and posterolateral thoracotomies, involving an incision
through the third and fourth intercostal space, have been used for the
repair of congenital heart lesions in children during the past thirty
years. We examined 28 patients who had undergone repair of atrial septal
defect, patent ductus arteriosus, and coarctation of the aorta as children,
through the anterolateral or posterolateral chest approach. Volumes of the
breasts and pectoral muscles were obtained by a method using plaster molds,
and linear dimensions of each chest side were measured. Questionnaires were
completed that delineated the patients' perception of asymmetry of the
chest. Infant breast tissue on cadavers was examined. We conclude that
standard anterolateral thoracotomies result in a high frequency of breast
or pectoral maldevelopment; 60% of our patients had a greater than 20%
difference in volume between the two sides. We propose a modified operative
approach that we believe will reduce the frequency of maldevelopment.
ARTICLES
Breast and pectoral muscle maldevelopment after anterolateral and posterolateral thoracotomies in children
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